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Surgical and hardware complications of subthalamic stimulation

A series of 160 procedures

From the Departments of Neurology and Neurosurgery, University of Kansas Medical Center, Kansas City, KS.

Address correspondence and reprint requests to Dr. Kelly E. Lyons, University of Kansas Medical Center, Department of Neurology, 3599 Rainbow Blvd., Mailstop 2012, Kansas City, KS 66160; e-mail: lyons.kelly{at}att.net

Objective: To assess the surgical and hardware complications in a series of 81 consecutive patients undergoing subthalamic (STN) deep brain stimulation (DBS) for Parkinson disease (PD).

Methods: The authors prospectively documented surgical and hardware complications occurring at the time of surgery and at subsequent neurologic and surgical evaluations for an average of 17 months, ranging from 1 to 54 months.

Results: No patient had a serious surgical complication resulting in death or permanent neurologic deficit. One patient had an intracranial hemorrhage but with no permanent deficit. In follow-up, 2.5% had infections requiring system removal, 3.7% had infections requiring implantable pulse generator (IPG) removal, 12.5% had misplaced leads, and 26.2% had hardware complications including lead migration, lead fracture, extension erosion, extension fracture, and IPG malfunction.

Conclusion: Serious complications leading to permanent neurologic deficit are rare after STN DBS for advanced PD. However, long-term follow-up demonstrated that hardware complications are relatively common, having occurred in approximately 26% of these patients.

Received September 24, 2003. Accepted in final form March 22, 2004.

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